腹腔镜肝囊肿开窗术治疗多囊肝的可行性及长期疗效观察

The feasibility and long-term outcomes of laparoscopic fenestration in the treatment of polycystic liver

目的:探讨腹腔镜肝囊肿开窗术治疗多囊肝的可行性及长期疗效。方法:回顾分析2003年至2010年为21例多囊肝患者行腹腔镜囊肿开窗术的临床资料,总结分析其术前情况、术后死亡率、术后并发症、术后囊肿及症状复发率。结果:手术顺利,无一例中转开腹。术后2例患者出现胆漏,其中1例伴少量胸腔积液,1例出现少量腹水,均保守治疗痊愈。术后随访24～103个月,平均49个月,2例囊肿复发,1例症状复发。结论:腹腔镜囊肿开窗术具有患者创伤小、康复快、复发率低等优点,术中联合应用多种有效手段,其并发症发生率及术后长期复发率逐渐降低,成为临床治疗多囊肝的有效术式。

Objective： This study was initiated to study the feasibility and long-term outcomes of laparoscopic fenestration in the treatment of polycystie liver. Methods ： Retrospective analysis was made on the clinical data of the 21 cases of polycystic liver from 2003 to 2010. All patients underwent laparoscopic fenestration. Perioperative parameters including preoperative situation, postoperative mortality, complications, cyst and symptoms recurrence rate were summarized and analyzed. Results：All laparoscopic operations were finished without converting to laparotomy. Postoperative complications occurred in three cases, including two cases of bile leakage, one of which coupled with a small amount of pleural effusion, and one ease of aseites. They were all cured with conservative methods. The mean follow-up period was 49 months （24-103 months）. There were two cases of cyst recurrence, and one ease of symptom recurrence. Conclusions ： Laparoscopic fenestration is an effective method for polycystic liver with advantages of little trauma, quick recovery and low recur- rence rate. Its complication rate and postoperative long-term recurrence rate could gradually decrease when many effective methods are used during operation.